People

Karl Dietrich enjoyed teaching high school biology and chemistry. But he felt something was out of balance.

“I had the sense,” he says, “that maybe 5 percent of my students would find the periodic table useful for their lives ahead—yet all of them would need to know about their personal health.”

Dietrich decided to learn more about health education by enrolling in the master’s in public health program at The Dartmouth Institute for Health Policy and Clinical Practice. The move gave Dietrich the opportunity to explore health systems and population health issues in depth, but he missed the one-on-one contact he’d had with students. Perhaps, he reasoned, the best way for him to encourage better health practices was the most direct one—by becoming a physician.

Geisel School of Medicine, with its emphasis on service-based medicine, has provided the perfect proving ground. As a first-year student, Dietrich and classmate Holly Schroeder leveraged their Schweitzer Fellowships to establish a migrant workers’ medical program for Mexicans working on dairy farms in the Upper Valley region.

With mentoring from Dr. Stephen Genereaux (Med’87) of Wells River, Vermont, Dietrich and Schroeder reached out to dairy farmers and workers in several rural towns. Their fluency in Spanish enabled them to converse with the men and build rapport. They learned to formulate the right questions about their patients’ health, and come up with an apt diagnosis and treatment plan. Genereaux oversaw their approach to ensure it was on target, but he also gave Dietrich and Schroeder as much autonomy as possible. During the next two years, they made regular visits and screened farm workers in seven locations. They helped coordinate follow up appointments, providing interpretation services and patient advocacy as needed.

Now in its fourth year, the project has grown to nine farms and includes more than a dozen Geisel medical students. “The beauty of the program is its simplicity,” says Dietrich. “A little effort on your part can make a profound difference in someone else’s life. That’s been a driving force behind my interest in primary care.”

Dietrich says his clinical rotations with other underserved populations in locations as diverse as Tuba City, San Francisco, and southern Maine, also helped reinforce his desire to work in family medicine.

“Primary care allows you to see people in the setting where they live and be familiar with the cultural constraints they face. As a family physician, you appreciate that life is complicated. Your patients are trying hard to manage tangible issues like jobs and families. Helping them understand why attending to this unseen thing—their health—matters is challenging, but ultimately rewarding.”

As this year’s Syvertsen Fellow, Dietrich looks forward to a career in clinical practice. But he’s also considering coming back to the classroom again someday to teach: this time with the next generation of primary care physicians.

“Dr. Syvertsen took it upon himself to establish personal connections to his students, to be invested in their lives,” say Dietrich. “This award has been a great affirmation that this perspective, which I share, is valued at Dartmouth. Community-oriented physicians are the kind of doctors we’re training to be.”